When should you start taking folic acid before pregnancy?

You should start taking a folic acid supplement at least one month before you start trying to conceive, because the neural tube, which becomes your baby's brain and spine, forms and closes in the third and fourth week of pregnancy, often before a woman even knows she's pregnant. Always consult your healthcare provider before starting any new supplement, especially during pregnancy, breastfeeding, or while trying to conceive. By the time a positive test shows up, that early window may have already passed.

Why timing matters more than most people realize

Fewer than 1 in 3 women get the amount of folic acid recommended by the U.S. Preventive Services Task Force, according to the American Academy of Pediatrics, and about half of pregnancies in the United States are unplanned. That combination means a lot of women are not covered during the exact window when folate matters most.

The CDC is direct about this: neural tube defects happen in the first few weeks of pregnancy, often before you know you are pregnant, and by the time you realize you're pregnant, it might be too late to prevent one. That's why the recommendation is to get 400 mcg of folic acid daily before and during early pregnancy, not just once you see two lines on a test.

Why methylated folate specifically

Folic acid supports healthy fetal neural tube development, and the bioavailable, methylated form (5-MTHF) is the form the body uses directly, without needing to convert it first.† This is especially relevant for women with MTHFR gene variations, who may not efficiently convert standard folic acid into its usable form.

Our prenatal with methylated folate and gentle iron uses 5-MTHF for this reason. Total Prenatal, designed for preconception through breastfeeding, is built around the preconception window specifically, not just the pregnancy itself.

"Even with fertility issues or trying to get pregnant, there's no magic pill. Addressing the whole body, mind and spirit, that's what works."

— Amy Suzanne Upchurch, Founder and CEO of Pink Stork

What a preconception routine can look like

• Start a prenatal with methylated folate at least one to three months before you plan to try to conceive.
• If you're also working on cycle regularity, our 40:1 myo-inositol and D-chiro-inositol blend is often layered alongside Total Prenatal during the preconception window to support hormonal wellness and ovarian health.†
• Talk with your provider about your specific folate needs, especially if you have a personal or family history of a neural tube defect, since higher doses may be recommended in that situation.

Frequently asked questions

How early should I start taking folic acid before trying to conceive?

Most guidance points to starting at least one month before conception, since neural tube development happens in the third and fourth week of pregnancy, often before a positive pregnancy test.

What if I get pregnant before I start taking a prenatal?

Start as soon as you know, and talk with your healthcare provider. Many women aren't on a folate routine before conception, since roughly half of pregnancies are unplanned.

What's the difference between folic acid and methylated folate (5-MTHF)?

Folic acid is the synthetic form found in most supplements and fortified foods; 5-MTHF is the already-active, bioavailable form the body uses directly.† It may be especially relevant for women with MTHFR gene variations.

Do I need a separate DHA supplement with my prenatal?

Total Prenatal includes algae-sourced DHA in each serving, so a separate DHA supplement generally isn't needed.†

Is Total Prenatal safe to take while trying to conceive, not just once pregnant?

Total Prenatal is formulated for preconception through breastfeeding.† Always consult your healthcare provider before starting any new supplement, especially during pregnancy, breastfeeding, or while trying to conceive.

Related reading

• Why choose a prenatal with methylated folate and gentle iron?
• Does ginger actually help with pregnancy nausea?
• Can inositol help with irregular periods?

Sources

• About Folic Acid, CDC
• Folic Acid for the Prevention of Neural Tube Defects, American Academy of Pediatrics
• Good Health Before Pregnancy: Prepregnancy Care, ACOG
• Neural Tube Defects, CDC

† These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare provider before starting any new supplement, especially during pregnancy, breastfeeding, or while managing a medical condition. Keep out of reach of children.